Survival after diagnosis of hypertension in cats attending primary care practice in the United Kingdom

Conroy, Megan; Chang, Yu‐Mei; Brodbelt, David; Elliott, Jonathan

doi:10.1111/jvim.15307

Cited by 21 publications

(25 citation statements)

References 21 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The proportions and age distributions represent the real distribution of cats seen by Banfield clinics over the last 20 years. Aging is associated with a range of chronic conditions and CKD is commonly diagnosed before or at the same time as hypertension, hyperthyroidism, and diabetes mellitus . To understand how the model performed in situations where multiple diagnoses were present in the EHR, we also evaluated whether misclassification for “no CKD” or “CKD” by the model was linked to specific comorbidities (Table ).…”

Section: Discussionmentioning

confidence: 99%

Predicting early risk of chronic kidney disease in cats using routine clinical laboratory tests and machine learning

Bradley¹,

Tagkopoulos

Kim

et al. 2019

Veterinary Internal Medicne

Self Cite

View full text Add to dashboard Cite

Background: Advanced machine learning methods combined with large sets of health screening data provide opportunities for diagnostic value in human and veterinary medicine.Hypothesis/Objectives: To derive a model to predict the risk of cats developing chronic kidney disease (CKD) using data from electronic health records (EHRs) collected during routine veterinary practice.Methods: Longitudinal EHRs from Banfield Pet Hospitals were extracted and randomly split into 2 parts. The first 67% of the data were used to build a prediction model, which included feature selection and identification of the optimal neural network type and architecture. The remaining unseen EHRs were used to evaluate the model performance.Results: The final model was a recurrent neural network (RNN) with 4 features (creatinine, blood urea nitrogen, urine specific gravity, and age). When predicting CKD near the point of diagnosis, the model displayed a sensitivity of 90.7% and a specificity of 98.9%. Model sensitivity decreased when predicting the risk of CKD with a longer horizon, having 63.0% sensitivity 1 year before diagnosis and 44.2% 2 years before diagnosis, but with specificity remaining around 99%. Conclusions and clinical importance:The use of models based on machine learning can support veterinary decision making by improving early identification of CKD. K E Y W O R D S artificial neural network, computer model, feline, machine learning, renal

show abstract

Section: Discussionmentioning

confidence: 99%

Predicting early risk of chronic kidney disease in cats using routine clinical laboratory tests and machine learning

Bradley¹,

Tagkopoulos

Kim

et al. 2019

Veterinary Internal Medicne

Self Cite

View full text Add to dashboard Cite

show abstract

“…There is a high variability between the values of SBP in hypertensive feline population cases of the published studies (range from 160 to 300 mm Hg) and the response to antihypertensive therapy, indicating that the cause of SH, the early detection of SH and the appropriate antihypertensive therapy could affect the final outcome of the cats 11,12,24,33 . Despite the poor prognosis in the current case series, early detection and administration of one or multiple antihypertensive drugs can improve cat's survival by decreasing the risk of severe secondary organ damage and its complications 6,11,31,35 …”

Section: Discussionmentioning

confidence: 79%

Severity of neurological signs in feline hypertensive encephalopathy may be reflected through brain histopathological lesions

Baka

Soubasis

Oevermann

et al. 2021

Vet Record Case Reports

View full text Add to dashboard Cite

Hypertensive encephalopathy (HE) was diagnosed in two aged cats with chronic kidney disease. The cause for admission was generalised epileptic seizures, with severe, interictal neurological dysfunction (dementia, locomotor dysfunction, cranial nerve deficits). Both cats had systolic hypertension (SH) (180‐220 mm Hg), bilateral retinal detachment, non‐regenerative anaemia and moderate renal azotaemia. Both cats died. Gross lesions were apparent in one cat consisting of white matter oedema in the parietal and temporal lobe and a focal area of malacia. Histopathological examination of brain tissue revealed bilateral severe oedema and astrocytic gliosis in the corona radiata, basal nuclei, thalamus and piriform lobe of both cats. Extensive hyaline and hyperplastic arteriolosclerosis, perivascular plasma exudation and haemorrhages were present throughout the meninges and neuroparenchyma. Histopathological findings reflected the severity of neurological deficits. This could indicate that the severity of the brain lesions is associated with the neurological manifestations of HE.

show abstract

“…36 Proactive monitoring of this population is vital, as hypertensive TOD is associated with significant morbidity and one UK epidemiological study documented improved survival in hypertensive cats diagnosed prior to clinical manifestations of disease. 37…”

Section: Diagnosismentioning

confidence: 99%

Feline comorbidities: The intermingled relationship between chronic kidney disease and hypertension

Lawson

Jepson

2021

Journal of Feline Medicine and Surgery

View full text Add to dashboard Cite

Practical relevance: Chronic kidney disease (CKD) is a highly prevalent disorder of senior cats. CKD is frequently diagnosed in association with hypertension, and the two conditions have an intermingled cause-and-effect relationship. Hypertensive target organ damage (TOD) to the eye, brain, heart and kidney significantly impacts the welfare of cats suffering from this comorbidity. Hypertension also drives proteinuria, which is an independent risk factor for progression and mortality in cats with CKD. Blood pressure monitoring and institution of effective antihypertensive treatment, where indicated, is therefore crucial in effective management of the feline CKD patient. Current guidelines recommend a target systolic blood pressure of <160 mmHg to minimise risk of TOD. Both amlodipine besylate and telmisartan are effective antihypertensive agents for use in these patients. Clinical challenges: Clinical signs of hypertension may not be apparent to owners of affected cats until severe hypertensive TOD is present. Despite this, blood pressure monitoring in cats with CKD is still infrequently performed, and hypertension likely remains underdiagnosed in this population. Evidence base: This review is based upon evaluation of the currently available published literature, including relevant consensus statements. There is a large body of evidence supporting the association between hypertension and CKD in cats. However, significant aspects, such as the mechanisms behind this association, and effect of hypertension and antihypertensive treatment on mortality and progression of CKD, remain unclear. Further research is therefore required in order to improve understanding of these conditions.

show abstract

Survival after diagnosis of hypertension in cats attending primary care practice in the United Kingdom

Cited by 21 publications

References 21 publications

Predicting early risk of chronic kidney disease in cats using routine clinical laboratory tests and machine learning

Predicting early risk of chronic kidney disease in cats using routine clinical laboratory tests and machine learning

Severity of neurological signs in feline hypertensive encephalopathy may be reflected through brain histopathological lesions

Feline comorbidities: The intermingled relationship between chronic kidney disease and hypertension

Contact Info

Product

Resources

About